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Accurate estimates of study product use are critical to understanding and addressing adherence challenges in HIV prevention trials. The VOICE trial exposed a significant gap between self-reported adherence and drug detection. The VOICE-D qualitative study was designed to better understand non-adherence during VOICE, and was conducted in 2 stages: before (stage 1) and after (stage 2) drug detection results were provided to participants. Transcripts from 44 women who participated in both stages were analysed to understand the effect of presenting drug detection data on narratives of product use. Thirty-six women reported high adherence in stage 1, yet admitted non-use in stage 2, three reported high adherence in both stages (contrary to their drug detection results) and five had consistent responses across both stages and drug results. Presenting objective measures of use may facilitate more accurate product use reporting and should be evaluated in future prevention trials.

In hypothetical playmate preference tasks, obese figures are rarely picked up as friends. This study aims to observe what happens in real life and examine the relationship between body-size and social status in children. Four-hundred and fourteen children aged 5, 7 and 9 years were given a sociometric test. The Body Mass Index (BMI) of each child was calculated. Children were classified as average, popular or with a negative social status. A negative association between body-size and popularity was found. Popular children had the lowest mean BMI, while neglected and rejected children had the highest. Not a single obese child was found to be popular while overweight children had more chances to be popular with increasing age. The findings suggest that obesity is a risk factor for children's social development as early as preschool age.

Based on a sample of 8271 mothers, this study explored a set of psychological and sociodemographic factors associated with their vocabulary, drawing on data from a large, nationally representative sample of children born in 2000. The dependent variable was maternal vocabulary assessed when cohort members were at fourteen years of age, and the mothers were in their mid-forties. Data were also collected when cohort members were at birth, 9 months old, and at ages 3, 7, 11 and 14 years. Correlational analysis showed that family income at birth, parent–child relationship quality at age 3, maternal educational qualifications at age 11, and maternal personality trait Openness at age 14 were significantly and positively associated with maternal vocabulary. It also showed maternal malaise at 9 months and children's behavioral adjustment at age 7, and maternal traits Neuroticism and Agreeableness at age 14 were significantly and negatively associated with maternal vocabulary. Maternal age was also significantly and positively associated with vocabulary. Regression analysis showed that maternal age, malaise, parent–child relationship quality, children's behavioral adjustment, maternal educational qualifications, and traits Openness and Agreeableness were significant predictors of maternal vocabulary, accounting for 33% of total variance. The implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

Most existing evidence-based sexual health interventions focus on individual-level behavior, even though there is substantial evidence that highlights the influential role of social environments in shaping adolescents' behaviors and reproductive health outcomes. We developed Yo Puedo, a combined conditional cash transfer and life skills intervention for youth to promote educational attainment, job training, and reproductive health wellness that we then evaluated for feasibility among 162 youth aged 16-21 years in a predominantly Latino community in San Francisco, CA. The intervention targeted youth's social networks and involved recruitment and randomization of small social network clusters. In this paper we describe the design of the feasibility study and report participants' baseline characteristics. Furthermore, we examined the sample and design implications of recruiting social network clusters as the unit of randomization. Baseline data provide evidence that we successfully enrolled high risk youth using a social network recruitment approach in community and school-based settings. Nearly all participants (95%) were high risk for adverse educational and reproductive health outcomes based on multiple measures of low socioeconomic status (81%) and/or reported high risk behaviors (e.g., gang affiliation, past pregnancy, recent unprotected sex, frequent substance use; 62%). We achieved variability in the study sample through heterogeneity in recruitment of the index participants, whereas the individuals within the small social networks of close friends demonstrated substantial homogeneity across sociodemographic and risk profile characteristics. Social networks recruitment was feasible and yielded a sample of high risk youth willing to enroll in a randomized study to evaluate a novel sexual health intervention.

This study explored correlates of the trait Conscientiousness drawing on longitudinal data from the Millennium Cohort Study (MCS), with a sample of 7,436 mothers. Data were collected when participants' children were born and again at ages nine months, 3, 11, and 14 years. Structural equation modeling showed that the family poverty indicator, self-esteem, parent-child relationship, children's behavioral problems, and education all had significant and direct effects on maternal trait Conscientiousness. The strongest predictor was self-esteem (measured over 13 years previously), followed by children's behavioral problems and parent-child relationship quality. The implications for helping mothers and their children are considered and limitations are discussed. [ABSTRACT FROM AUTHOR]

This study set out to examine to what extent a set of psychological, health and socio‐demographic factors are associated with self‐efficacy (SE) in a large sample of over 12,000 participants over a two‐year period. We were interested in the correlates of self‐efficacy (criterion variable) with gender, age, education and occupation, the Big‐Five personality factors and cognitive ability, as well as mental and physical health (predictor variables). Regression analyses showed that four of the Big‐Five personality factors (extraversion, neuroticism, conscientiousness, and openness), cognitive ability, mental and physical health, gender, education and occupation were all significant and independent predictors of self‐efficacy, accounting for 23% of the variance of the outcome variable. Personality variables, particularly Neuroticism and Conscientiousness, were the most powerful predictors of SE two years later. The implications for encouraging SE in individuals are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background We examined the use of male condoms and the diaphragm following completion of a clinical trial of the diaphragm's HIV prevention effectiveness. In the trial, called Methods for Improving Reproductive Health in Africa (MIRA), women were randomized to a diaphragm group (diaphragm, gel and condoms) or a condom-only control group. At trial exit, all women were offered the diaphragm and condoms. Methods Our sample consisted of 801 Zimbabwean MIRA participants who completed one post-trial visit (median lapse: nine months; range two to 20 months). We assessed condom, diaphragm and any barrier method use at last sex act at enrolment, final MIRA and post-trial visits. We used multivariable random effects logistic regression to examine changes in method use between these three time points. Results and discussion In the condom group, condom use decreased from 86% at the final trial visit to 67% post trial (AOR = 0.20; 95% CI: 0.12 to 0.33). In the diaphragm group, condom use was 61% at the final trial visit, and did not decrease significantly post trial (AOR = 0.77; 95% CI: 0.55 to 1.09), while diaphragm use decreased from 79% to 50% post trial (AOR = 0.18; 95% CI: 0.12 to 0.28). Condom use significantly decreased between the enrolment and post-trial visits in both groups. Use of any barrier method was similar in both groups: it significantly decreased between the final trial and the post-trial visits, but did not change between enrolment and the post-trial visits. Conclusions High condom use levels achieved during the trial were not sustained post trial in the condom group. Post-trial diaphragm use remained relatively high in the diaphragm group (given its unknown effectiveness), but was very low in the condom group. Introducing "new" methods for HIV prevention may require time and user skills before they get adopted. Our findings underscore the potential benefit of providing a mix of methods to women as it may encourage more protected acts.

The acceptability and use of the diaphragm and lubricant gel were assessed as part of a large randomized controlled trial to determine the effectiveness of the methods in women’s HIV acquisition. 2,452 intervention-arm women were enrolled at five Southern African clinics and followed quarterly for 12–24 months. Acceptability and use data were collected by face-to-face interviews at Month 3 and Exit. Participants were “very comfortable” with the physical mechanics of diaphragm use throughout the trial, and approval of the gel consistency, quantity and the applicator was high. At Exit, consistent disclosure of use (AOR 1.97, 95% CI: 1.10–3.55); an overall high diaphragm rating (AOR 1.84, 95% CI: 1.45–2.34) and perception of partner approval (AOR 1.75, 95% CI: 1.35–2.26) were the most significant acceptability factors independently associated with consistent use. Despite being female-initiated, disclosure of use to male partners and his perceived approval of the products were factors significantly associated with their consistent use.

Vaginal practices may interfere with the use and/or the effectiveness of female-initiated prevention methods. We investigated whether vaginal practices differed by randomization group in a phase III trial of the diaphragm with lubricant gel (MIRA) in Sub-Saharan Africa (n = 4925), and if they were associated with consistent use of study methods. At baseline, vaginal practices were commonly reported: vaginal washing (82.77%), wiping (56.47%) and insertion of dry or absorbent materials (20.58%). All three practices decreased during the trial. However, women in the intervention group were significantly more likely to report washing or wiping during follow-up compared to those in the control group. Additionally, washing, wiping, and insertion, were all independently and inversely associated with consistent diaphragm and gel use and with condom use as well, regardless of study arm. A better understanding of the socio-cultural context in which these practices are embedded could improve educational strategies to address these potentially modifiable behaviors, and may benefit future HIV prevention interventions of vaginal methods.